{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T07:56:37Z","timestamp":1790754997670,"version":"4.1.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Unintentional ingestions in children are a common presenting chief complaint in the emergency department (ED). The decision to consult social work or report to Child Protective Services (CPS) relies on the provider\u2019s discretion. We sought to investigate the association between race or insurance status and providers\u2019 decisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective cross-sectional study of children younger than 6 years of age presenting to 1 of 6 hospitals within the Yale New Haven Health system in 2013 to 2021 with an ICD-9\/10 code of poisoning or accidental ingestion. Multivariable logistic regression was used to assess factors associated with social work and CPS consults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Among 759 children with unintentional ingestions, there were 467 (48.4%) ingestions of over-the-counter substances, 359 (47.3%) ingestions of prescription medications and 24 (3.2%) ingestions of illicit substances. Medication error by caregiver accounted for 46 cases (6.1%). Social work was consulted in 23% of cases. Factors associated with social work consults were changes in baseline mental status and vital signs (adjusted odds ratio [aOR]=3.35 [95% CI: 1.62-6.92]), requiring inpatient care (aOR=14.3 [8.04-25.6]), PICU admission (aOR=24.5 [5.57-107.9]), and having toxicology tests ordered (aOR=3.2 [1.85-5.51]). Presentation to a general ED decreased the odds of a social work consult (aOR=0.14 [0.08-0.24]). CPS reports were filed in 6.7% of cases. Factors associated with CPS reports were ingestion type (prescription aOR=2.73 [95%CI 1.19-6.27]; substances illegal for a minor [eg, alcohol, nicotine, THC-containing products] aOR=21.8 [6.76-70.4]), change in mental status or vital signs from baseline (aOR=3.18 [1.39-7.26]), requiring inpatient care (aOR=4.17 [1.95-8.91]) PICU (aOR=6.23 [95%CI 1.67-23.3]) and having toxicology tests ordered (aOR=3.6 [1.71-7.57]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In children presenting after unintentional ingestion, involvement of social work or CPS was associated with clinical severity and substance type but not with race or insurance status.<\/jats:p>\n                  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